Luigi Solbiati MD, Presenter: Nothing to Disclose

Tito Livraghi, Abstract Co-Author: Nothing to Disclose

Tiziana Ierace, Abstract Co-Author: Nothing to Disclose

Franca Meloni MD, Abstract Co-Author: Nothing to Disclose

Luca Cova, Abstract Co-Author: Nothing to Disclose

S. Nahum Goldberg MD, Abstract Co-Author: Nothing to Disclose

To report the 5-year survival of patients with liver colorectal metastases treated with percutaneous radiofrequency ablation (RFA) and to compare with the latest 3-year survival.

In 184 patients, 392 metachronous liver metastases from colorectal cancer (0.6 – 5.2 cm in size; mean 2.3 +/- 1.1 cm) were treated with US-guided RFA, using internally-cooled electrodes (Valleylab, Boulder, USA). 138 of the 352 (39.2%) tumors were > 3 cm. Indications for RFA were non-surgical candidates as independently determined by surgeons (n = 102, 55.4 %), refusal of surgery (n = 35, 19 %) and the “test of time” approach prior to possible surgical resection (n = 43, 23.4%). Follow-up lasted from 12 to 76 months (mean = 38.2 months). Results of the patients treated since January 2000, when stricter criteria for patient enrollment, treatment and follow-up were adopted (i.e., more accurate imaging methods for early diagnosis and guidance, immediate RFA after detection, and creating larger ablative margins) were analyzed separately and compared to the overall group. This subgroup of 61 patients had 118 metastases of which only 14/61 (22.9%) were > 3 cm.

In the entire study group, local tumor control was achieved in 266/392 (67.9%) metastases. No deaths and only two (1.1%) major complications related to RFA were observed. Overall survival rates at 1-2-3-5 years were 96.2%, 64.2%, 45.7% and 22.1%, respectively. The estimated median survival was 33 months. In the subgroup of patients treated after January 2000, local tumor control was achieved in 98/118 (83.1%) lesions and survival rates at 1-2-3 years were 94.5%, 79.5% and 59.7%, respectively.

Long-term survival of patients treated with RFA for colorectal metastases is constantly increasing, with very low morbidity rates. In the subgroup of patients treated in the last four years, the 3-year survival rate (59.7%) has equaled that of the best surgical series reported in the literature. However, it is important to point out that this improved survival may be due in part to our treating of earlier and smaller tumors.

Solbiati, L, Livraghi, T, Ierace, T, Meloni, F, Cova, L, Goldberg, S, Radiofrequency Ablation for Liver Colorectal Metastases: Is It Possible to Equal the 5-year Survival Rates of Surgery?.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4414908.html